ABSTRACT
Background: Teenage pregnancy as a vulnerable group of obstetric patients remains a global public health concern, with heterogeneous trends reported during the COVID-19 pandemic. While some low- and middle-income countries documented increases in adolescent pregnancies, other regions showed stability or even reductions. Romania has persistently high rates of adolescent pregnancies, but little is known about the impact of the pandemic on very young adolescents. This study aimed to assess whether the COVID-19 pandemic influenced the incidence of pregnancies and delivery outcomes among girls under 16 years of age in Romania. Material and Methods: A retrospective observational study was conducted, including all live births among girls aged 12–16 years between January 2018 and December 2024. Variables analyzed were maternal age, year of birth, and mode of delivery (spontaneous vs. cesarean section). Three time periods were defined: pre-pandemic (2018–2019), pandemic (2020–2021), and post-pandemic (2022–2024). Results: A total of 414 births were recorded. Annual cases ranged from 42 in 2020 to 76 in 2019. The majority occurred among 15–16-year-olds, while pregnancies at ages 12–13 were rare. Spontaneous vaginal delivery predominated, with cesarean sections accounting for 9–19% annually. Statistical testing revealed no significant differences between periods in either the number of births (H = 2.20, p = 0.332) or delivery mode (χ²(2) = 0.36, p = 0.835). Conclusions: Despite pandemic-related disruptions in access to reproductive health services, there was no increase in pregnancies among adolescents under 16 years in Romania. However, the concentration of cases in the 14–16 age group highlights the need for targeted reproductive health interventions and continuity of care during health system crises.